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Should cardiac disease prevent autologous blood donation?
L J McCarthy1, C Danielson, M Pugh
1Department of Pathology, Indiana University Medical Center, Indianapolis 46202-5283, USA.
Insights
Patients with significant heart disease can safely donate blood. This study found no adverse effects in cardiac patients who donated autologous blood, challenging common beliefs about donation risks.
Area of Science:
- Cardiology
- Transfusion Medicine
- Public Health
Background:
- Public concern over infectious blood transfusions (e.g., AIDS) impacts blood donation.
- Autologous blood donation is underutilized.
- Cardiac disease often disqualifies blood donors due to perceived health risks.
Purpose of the Study:
- To assess the safety and tolerability of blood donation in patients with significant cardiac disease.
- To challenge the assumption that cardiac conditions preclude blood donation.
Main Methods:
- Sixty-eight donors (ages 14-84) with documented cardiac conditions (ischemic or valvular heart disease) donated 111 units of whole blood.
- No erythropoietin or routine volume replacement was used.
- Donors were informed of potential risks but donated willingly.
Main Results:
- No donor experienced adverse consequences from donating blood.
- The majority of donors had ischemic heart disease (59) or valvular heart disease (9).
- A significant portion of donated units (50%) were transfused to patients (54%).
Conclusions:
- Patients with well-established cardiac diseases can generally tolerate blood donation.
- Current disqualification criteria for blood donation based on cardiac history may be overly restrictive.
- Further research could support expanded criteria for autologous blood donation in cardiac patients.
Abstract:
AIDS has created considerable concern among the public regarding being transfused with potentially infectious blood. However, autologous blood donations are still not maximally provided nor utilized. Significant heart disease disqualifies all allogeneic and most autologous blood donors (American Association of Blood Banks (AABB) Standards 1994). Disqualification is based on the widespread belief that donating blood could possibly be detrimental to their health. However, this belief has not been sufficiently documented. Sixty-eight donors (ages 14-84 years), all with histories of significant cardiac diseases, donated 111 units of whole blood (1-3 units). Twenty-eight patients donated 1 unit, 37 donated 2 units, and three patients donated 3 units. Fifty-nine patients had ischemic heart disease, and nine had valvular heart disease (five with mitral stenosis and four with mitral valve prolapse). No patient received erythropoietin, and only one received equal volume replacement with normal saline during donation. All these patients eagerly wished to donate in spite of being informed of the possible complications. No patient wishing to donate has been refused, and none has experienced any adverse consequences from donating. Forty-four patients underwent total hip/knee replacements. Only 56 units (50%) were transfused to 37 patients (54%). Although our experience is limited, it appears that many patients with histories of well established cardiac diseases can easily tolerate donating blood without compromising their health.